Health

Perinatal factors associated with respiratory distress syndrome

Article Abstract:

Respiratory distress syndrome (RDS), a lung disease affecting newborns, is a common complication of prematurity. The lung tissue is rigid and has difficulty expanding because of a lack of surfactant, a substance that makes the lung tissue flexible. Although the outcome of infants with RDS has improved with neonatal intensive care, the management of RDS is still a concern. Efforts to reduce or prevent RDS include hospitalization of mothers at risk, bed rest, monitoring of fetus and continuous assessment of fetal well-being. Measures used to control the onset of labor can help prevent RDS from developing. To identify factors during pregnancy that may reduce the incidence of RDS, 298 infants born to 263 mothers at under 37 weeks of pregnancy were evaluated. The earlier the infant was born, the greater the risk for RDS. Premature rupture of membranes (PROM), the leakage of fluid surrounding the fetus, carries the risk of maternal infection if delivery is not initiated within 24 hours. Membranes that had been ruptured for longer than 24 hours without maternal infection actually protected the infants from RDS. The incidence of RDS after PROM was 10 percent among infants born 30 to 35 weeks into pregnancy and 50 percent among those born at 24 weeks. The risk for RDS was two times higher in infants born without PROM. A cesarean delivery without a trial of labor increased the chance of RDS. Drugs that control early labor were not helpful in reducing RDS, but corticosteroid therapy given 72 hours before delivery was protective. A conservative management of PROM and a vaginal delivery when possible can help protect infants from RDS. (Consumer Summary produced by Reliance Medical Information, Inc.)

Gestational diabetes: a triage model of care for rural perinatal providers/(Transactions of the Sixty-Second Annual Meeting of the Pacific Coast Obstetrical and Gynecological Society)

Article Abstract:

Women with pregnancy-related diabetes may be treated successfully by rural health care providers without a team of diabetes specialists. Researchers in rural northern California compared the pregnancy outcomes of 39 women with gestational diabetes treated by rural doctors alone to the outcomes of 48 women treated by a multidisciplinary team of providers specializing in gestational diabetes. The two groups delivered their babies at similar gestational ages, and infant outcomes were good in both groups. Use of rural providers alone could reduce costs without compromising care.

Changing patterns in regionalization of perinatal care and the impact on neonatal mortality

Article Abstract:

Many high-risk infants in Missouri are still being delivered at level I and level II hospitals. In 1976, the March of Dimes Committee on Perinatal Health recommended transferring high-risk infants to level III hospitals. These larger hospitals provide more services than level I and II hospitals, including neonatal intensive care units. Researchers found that 14% of very-low-birth-weight infants in Missouri are delivered at level I and II hospitals. Infants delivered at level II hospitals have more than twice the mortality rate as those delivered at level III hospitals.